Esophagostomy tubes (e-Tubes) are narrow; flexible tubes that are surgically inserted into the neck and esophagus of animals that cannot or will not eat normally due to oral or metabolic disease or other processes. Such situations commonly arise in animals receiving chemotherapy for cancer with accompanying nausea, those having oral pain or tumors, etc. Caregivers pass formula and medications through the e-tubes to ensure adequate nutrition for a period which may last for weeks or months.
The e-tube is a foreign agent to the animal's immune system, and the insertion point remains as an open wound. Common problems with e-tube patients include damage from the animal scratching at the wound/insertion site, stitches or the tube itself, infection, or tube removal by the animal. The tube is attached to the neck skin with sutures which can break away from the skin after days or weeks, leaving the tube unanchored, and if not adequately bandaged, the animal can dislodge and remove the tube by vigorously shaking its head or pawing the tube out.
In an ideal setting, a bandage should have a contact layer, an absorbent layer, and an outer layer. The absorbent layer is in place to absorb liquid from the wound when it is fresh, and to hold the contact layer in place. Once the wound has begun to heal, this layer may not be necessary. The outer layer functions to support the contact layer. It should be in contact with the skin (hair) at the bandage margins, anchoring the bandage so it will not slip. It should be applied smoothly and snugly, but not tight enough to cut off blood circulation. Current method of bandaging is for the veterinarian to place a non-adherent pad, encircle the animal's neck with gauze and cover that with adhesive bandage. This dressing is less than ideal as it gets wet easily, does not stabilize the tube, frays, rolls up and shifts on the animal's neck, and has to be replaced by the veterinarian frequently.
The need exists for a covering that will: protect the wound/tube insertion area, hold and stabilize the tube and prevent accidental or deliberate removal by the animal, be washable, be easy to apply and remove, require minimal dressing of the wound, allow it to “breathe”, stay on continuously, and cause no discomfort to the animal nor be an impediment to normal eating, grooming, or play.